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Gaps in screening and support
According to the Canadian Stroke Best Practice Recommendations (CSBPR), everyone who has experienced a stroke should be considered at risk for post-stroke mental health issues, which can occur at any stage of recovery. Yet screening is not happening as often as it should.
“When Heart & Stroke surveyed stroke prevention clinics across the country, we found that only 54% reported that they routinely screened for post-stroke depression,” says Dr. Lindsay.
Dr. Tennen believes increasing awareness and resources around mental health after stroke could improve the situation. “I think physicians and other health care professionals work very hard to manage the physical aspects of stroke and recovery, but the systems and resources needed to screen patients and then to treat them, are often lacking. I think patients should be educated about emotional changes following stroke and they should also be screened. People often suffer in silence until they are asked the specific screening questions.” When mood issues are routinely addressed, they become normalized and destigmatized.
Lilli’s story
If women are not being screened and identified, they cannot be referred to the services they need. Yet there are additional challenges even if screening takes place. “Screening is important, but it is also difficult because there are not a lot of resources available. You ask the questions and then you’re kind of stuck,” says Dr. Blake. Her rehabilitation centre integrates psychology across the healthcare teams, but she knows this is not the case for most programs.
Lack of services across the country
There are access challenges to mental health services across the country. According to Statistics Canada, in 2018 roughly 5.3 million people in Canada said they needed some help for their mental health in the previous year — and almost half said their needs were partially or completely unmet. The reasons